Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
How to Identify Revenue Leakage in a Medical Practice: A Six-Point Checklist
Leakage hides in small, repeatable failures. Here is a practical method for finding it: the six places to look, the exact reports to pull, how to put a dollar figure on each finding, and how to assign every leak to a process owner and a weekly check.
Small-Practice Breach Response: The First 72 Hours and Who to Call
The IT vendor calls at 4:40 on a Friday: the files are encrypted. What the practice does in the next three days decides the cost of the next year. Here is a breach response plan for a small medical practice: containment, the call list in order, the incident log, the 60-day HIPAA clock and the risk assessment.
Common Credentialing Delays and How Practices Can Prepare for a New Provider
Most payer enrollment delays are caused before the application is submitted. Here is what payers reject, what they wait for, a realistic timeline by payer type, and the preparation checklist to start the day an offer is accepted.
Credentialing in September for January: Revalidations, Contracts, New Plans
January 1 is when payer contracts renew, plan networks change and revalidations that were ignored all year come due. Here is the September credentialing review we run for practices, with the checks, the deadlines and the file you should be able to produce for every provider.
OB Global Package Billing and Well-Woman Visits: What Is Included, What Is Not
The obstetric global package pays one fee for months of care, which is exactly why it gets billed wrong. Here is what 59400 and its siblings include, when the antepartum-only codes 59425 and 59426 apply, how to split a pregnancy across two payers or two practices, and how well-woman visits differ from a problem visit.
Medicare Advantage Non-Contracted Providers: Payment, Appeals and the Waiver
A practice that treats a Medicare Advantage patient without a contract is not out of luck. Federal rules set what the plan must pay, how fast, and how to appeal a denial. Here is how the payment floor works, why the waiver of liability form matters, and the mistakes that turn a payable claim into a write-off.
What Practices Should Review Before Outsourcing Medical Billing
Outsourcing billing changes who does the work, not who is responsible for the revenue. Here is what to examine in your own practice first, the questions that separate a billing company from a claim-submission service, and what the agreement must say.
FDA Approves 2026-2027 COVID-19 Vaccines: What Practices Set Up Before Billing
On August 27, 2026 the FDA approved four updated COVID-19 vaccines for the 2026-2027 season, targeting the XFG variant and limited to adults 65 and older and younger people with risk conditions. What that means for eligibility screening, vaccine codes and CMS pricing, administration billing and the front desk.
Denial Root-Cause Analysis vs Denial Follow-Up: Why You Need Both
Follow-up fixes the claim on your screen. Root-cause analysis finds the forty others like it and stops the next forty. Most practices only do the first. Here is how to do the second with a denial log, eight categories and a monthly hour, without a data team.
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